From the Research
The primary purpose of a Thoracolumbosacral Orthosis (TLSO) brace is to provide external support and stability to the spine, limiting movement and reducing pressure on the vertebrae to promote healing in conditions such as spinal fractures, post-surgical stabilization, scoliosis, and degenerative disc disease. The TLSO brace is a rigid back brace that supports the spine from the thoracic region down to the sacrum, and its use has been studied in various contexts, including the treatment of thoracolumbar spine fractures 1. Some studies have shown that the use of a TLSO brace can reduce spinal movement and provide stability to the fracture site 2, while others have highlighted the potential drawbacks of prolonged brace use, including diminished lung capacity, skin breakdown, and paraspinal muscular atrophy 1. In terms of patient outcomes, a study published in 2020 found that the use of a semi-rigid TLSO brace can decrease forefoot pressures in elderly subjects with spinal hyperkyphosis, potentially reducing the risk of falls and mortality 3. Another study published in 2017 compared the effectiveness of Rigo Chêneau orthoses and Boston-style TLSOs in the treatment of adolescent idiopathic scoliosis, finding that patients treated with Rigo Chêneau orthoses had lower rates of spinal surgery and major curve progression 4. However, the most recent and highest-quality study on the topic, published in 2022, suggests that the use of a TLSO brace may not be as effective as previously thought, with many patients reporting inadequate advice and interference with daily activities, and a significant proportion of patients coming off the brace earlier than advised 1. Therefore, the use of a TLSO brace should be carefully considered on a case-by-case basis, taking into account the individual patient's needs and circumstances, and with careful monitoring of potential complications and outcomes. Key considerations for patients wearing a TLSO brace include maintaining proper hygiene, inspecting the skin daily for pressure sores, and following the healthcare provider's instructions for wear and care. Ultimately, the goal of TLSO brace treatment is to promote proper healing, prevent further injury, and improve patient outcomes, while minimizing potential drawbacks and complications.